Benjamin T Russell Dmd LLC

NPI #1881247039 in Gresham, Oregon

Provider Information

NPI Number: 1881247039
Entity Type: Organization
Organization Name: Benjamin T Russell Dmd LLC
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Jul 17, 2019
Last Updated: Jul 17, 2019

Practice Location

Address: 742 NE DIVISION ST STE 102
City: Gresham
State: Oregon
ZIP Code: 97030-3979
Phone: (503) 667-2442

Authorized Official

Name: DR. BENJAMIN RUSSELL
Title: OWNER
Phone: (503) 667-2442

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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